13 Flashcards
The goals of bandaging include:
limiting hemorrhage
immobilizing the area
preventing further trauma or contamination of the wound
preventing wound desiccation
absorbing exudate
controlling infection
aiding in mechanical debridement of the wound
When constructing bandages, several principles must be followed to avoid complications. The bandages
should be sufficiently padded, applied evenly and snugly, composed of three layers (primary, secondary, and tertiary), and placed to avoid traumatizing the newly formed granulation tissue or epithelium.
The_________________________________to allow tissue fluid to pass through to the secondary layer. The first layer may be an_______ or ________dressing.
first or primary layer directly contacts the wound
adherentornonadherent
A _________ dressing is usually a fine mesh or foam, nonstick material. This layer prevents tissue desiccation and causes minimal trauma. An adherent bandage uses a wide mesh material that allows tissue and debris to become incorporated into the bandage. This debris is then removed with the bandage change. However, because they are nonselective, healthy tissue may also be damaged.
nonadherent
Adherent bandages areclassified as _____,______,_____based on the composition of the primary layer. Dry-to-dry bandages consist of dry gauze applied to the wound. The bandages are painful to remove but enable significant tissue debridement. Wet-to-dry bandages are made with saline-moistened gauze placed directly on the wound. They are also painful to remove but result in less tissue desiccation than dry-to-dry bandages. Wet-to-wet bandages tend to damage the tissue bed by keeping it too moist.
dry to dry, wet to dry, or wet to wet
The__________ absorbs tissue fluid, pads the wound, and supports or immobilizes the limb. This layer is typically composed of cast padding or roll cotton.
secondary layer of a bandage
The________ functions to hold the primary and secondary layers in place, provide pressure, and keep the inner layers protected from the environment. This layer is composed of adhesive tape or elastic wraps.
tertiary layer
Bandages have a number of potential complications. Bandages applied too tight can result in neurovascular compromise and subsequenttissue necrosis. In some cases this damage can result in loss of a limb.
______ are used to help keep wounds moist for optimal healing. This can also result in excess moisture left in contact with healthy skin. The enzymes in wound exudate can cause_______(___) in healthy skin. ______ may also be induced by retention of urine or fecal matter within the bandage. Commercial barrier creams are available to protect healthy skin from MASD.
Bandages
moisture-associated skin damage(MASD)
MASD
Dressings are designed to aid in wound healing.
The ideal dressing should:
be nontoxic
protect the wound
keep the environment moist
be minimally painful to the patient
be cost effective
Dressings are designed to aid in wound healing.
The ideal dressing should:
be nontoxic
protect the wound
keep the environment moist
be minimally painful to the patient
be cost effective
It may also aid in
debridement, absorb exudate, or deliver topical agents to the wound. Thosetopical agentsmay include honey, silver, other antimicrobials, or any agent that speeds wound healing.
have a large fluid content, which adds water to the wound bed.Designed for dry or necrotic wounds, these dressings should not be used in highly exudative wounds.
Hydrogel dressings
are occlusive dressings that are nearly impenetrable to bacteria.They can donate fluid to the wound and are useful in dry wounds.The dressing permits autolytic debridement by keeping the wound moist.Hydrocolloid dressings should be used with caution in veterinary patients.Due to differences in skin physiology, these dressings do not adhere well to the skin of most veterinary patients.
Hydrocolloid dressings
may be composed of polyurethane or silicone.Many of the newer dressings also incorporate nanocrystalline silver.Because of the nature of the foam, these dressings can absorb significant exudate.In addition, they can add some protection to the wound.A compressive bandage around the dressing may compromise some of the beneficial effects of a foam dressing.
Hydrofoam dressings
usually contain calcium and may also be combined with silver or honey.Indicated for exudative wounds, these dressings absorb wound exudate to form a gel on the wound surface. Alginates also have some hemostatic benefits and cause minimal pain on removal.They are contraindicated in dry wounds
Alginate dressings
